Healthcare Provider Details

I. General information

NPI: 1891082103
Provider Name (Legal Business Name): LINDA P DOLAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA P WARWICK

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

IV. Provider business mailing address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

V. Phone/Fax

Practice location:
  • Phone: 317-718-2948
  • Fax:
Mailing address:
  • Phone: 317-718-2948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71003624B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: